This came from the VBAC group set up in the wake of the implosion of Jen Kamel’s VBAC group.

You may recall that the group imploded after they cluelessly boasted about their VBAC rupture rates, not realizing that they were 70% higher than typically quoted rates. Someone asked Kamel to comment on the fact that the rate was so high and she responded by deleting the question. It went downhill from there.

“Fighting the doctor for my vbac!”

At least one new group was set up to support women in ignoring medical advice in attempting a VBAC. Cassandra was part of that group. When she cancelled her scheduled C-section she received nothing but support.

40+6 today! Yesterday was my scheduled c-section that I declined. Fighting the doctor for my vbac! She gave me the run around; clinic director called and did the same. They treated me like I was ridiculous for having hope that I could go into labor even by my 41 week mark tomorrow. Lost my plug all day yesterday. Started contractions at 6am this morning! Been consistent & getting stronger!

Group members cheered her on:

S: Good for you, Keep up the strength and your vbac goal…

H: Good for you for standing your ground!! You’re on your way to a successful vbac!! Rock it Mama 🙂 …

A: You go momma! You got this! …

H: Of course they called … they are losing money if you don’t submit to unnecessary surgery. 😏 …

B: Doing fantastic honey. Good luck 💕💕💕💕

J: GO YOU! Determined mama, you WILL GET THIS VBAC!!! …

D: You’ve got this! Listen to your body & believe that you were born with the ability to birth a baby! …

Cassandra announces that she’s heading in to the hospital.

M Own your VBAC girl go get it!! …

S: I went into labor at 40+6. Baby was born ten minutes after midnight on 41 even. Go get it, mama!

A: Good for you girl. Your body. Your birth! You got this …

M: Good for you sweetheart! Don’t ever let someone dictate what will be done to your body! You continue to advocate for yourself. I’m so happy for you and proud of you!

J: Go mama! You’re amazing and brave for standing up to them and fighting for your vbac! Congrats!!!!!

And then this:

We got to the hospital and they couldn’t find a heartbeat. Did several tests and there are no signs of life.

She continues:

She was perfect on Tuesday for the biophysical scan. Thursday labored all day. When they told me no heartbeat my labor stalled. I am still laboring… We are devastated that we won’t get to raise our baby girl but I am thankful for the small blessing through this tragedy… We don’t know why this happened but we are thankful for Catalrina’s life and know that we will see her again one day in heaven.

Ultimately the baby was born vaginally. Cassandra got her VBAC just like her cheerleaders predicted. Sadly, her baby was dead, just like her doctor feared.

It’s hard to say anything about this article because we don’t have all of the relevant facts. We don’t know why this baby died or whether or not it was related to the doctor’s recomendation for surgery. You mention uterine rupture at the beginning of the article but this wasn’t what happened here. In fact we have very limited information in regards to anything. If she hadn’t had a previous c section would the doctor still have recommended one in this case?

MaineJen

Clearly the doctor was concerned for the baby’s welfare from the get go, as he/she and others from the clinic scheduled the c section and called when this woman didn’t show. Postdates babies are at risk for placenta failure. No, we don’t know exactly what happened, but we have clear evidence that this woman went against medical advice with disastrous results.

Natalie Meade

Her baby was healthy Tuesday (what time we don’t know?), her C-section had been booked by her doctor on the Wednesday (what time we don’t know?), her baby could easily have passed on the Tuesday night or Wednesday morning and have been dead by the time any C-section may have been performed, assuming the mother wanted major abdominal surgery. A C-section is no guarantee of removing a baby alive or in good health. This baby could possibly have passed away even if removed surgically. Babies fail for all sorts of reasons and many stillborn are due to an unknown cause of death. Like SIDS.

Montserrat Blanco

You are right, the baby could have died on Tuesday night after the scan. Reading some comments below you will find out that the first time she was offered a CS was a week before it was scheduled, at 39+something weeks. Her doctor was concerned because she had high blood pressure, as she had on Tuesday. I am pretty certain the scheduled day on Tuesday was a compromise between her wishes and her doctor opinion, that would likely been to perform a CS as soon as possible. In that highly likely scenario she would have a live healthy baby if she agreeded to the first date possible for the CS.

Azuran

Indeed, it could have been dead either way. BUT her chances of having a live baby would have been higher if she had followed medical advice.
I totally support her right to refuse medical intervention. But she made her choice, and how has to accept her own role in this. ‘babies die in hospital too’ isn’t a good excuse.
She chose the riskiest option and ended up with a dead baby. In all likelihood, the outcome most likely would have been different if she followed medical advice. Now she has to live with it.

Lissie

I have zero sympathy for this disgusting woman who killed her baby, ZERO. She chose to be a selfish bitch and carry on with her performance piece and she and her cheerleaders should be prosecuted. What happened to motherly instinct? Oh right, can’t have that get in the way of me me me.

But someone like me, who would let herself die or be maimed for her child, can’t get pregnant and has had a third foster adoption placement fail because the system is biased against military families even though none of these three kids have any contact with any bio family and thus no reason to need them to stay in the area. It’s disgusting how people like that get to have kids and people who would put their children first like my husband and I are left with nothing.

Empress of the Iguana People

i’m sorry, that sucks

chloe b

Talk about adoptoraptor. You are not entitled to raise someone else’s child because you see yourself as a better person. It’s not some other woman’s responsibility to provide you with a child.

Ayr

What is wrong with these women that they think it is OK to encourage another woman to go against the advice of doctor, who by the way knows far more than they do. They didn’t spend all those years in college to not know what they are talking about and just arbitrarily tell a woman who has had one c-section that it is best she have another to lower the chances of difficulties.

chloe b

I figure that you don’t know what placenta acreta is?

Ayr

It is when the placenta grows to deeply into the uterine wall, but what has that got do with this woman willfully ignoring her doctors advice and listening others who do not have a medical degree and do not know her history.

Montserrat Blanco

I am so so so sorry for the dead baby…I am lost for words.

Felicitasz

PLEASE tell me this is not real.
Words fail me.

Dr Amy, thanks for your blog, again.

KeeperOfTheBooks

While I’m miserable thinking of this mom’s baby and about how she’s going to feel when reality crashes down on her, I can also understand the desire for a VBAC. I really, really can. I want more kids, and I absolutely do. not. want. another C-section. Ever. I hate them, I never want another, and right now my feelings of “I don’t ever want another C-section” are much stronger than my feelings of wanting a big family.
However, rather than following my personal desire to get pregnant again in six months to a year and then hire a midwife for a HBA2C, DH and I are avoiding indefinitely until I can wrap my head around a third CS. Why? Because the point is to have a baby, not an experience, and that plan is a colossally stupid idea nine ways from Sunday. Ergo, rather than risk my and a baby’s life, I’m avoiding until I can say that I won’t resent a baby fiercely for being the reason for another C-section. Big girl panties, and all that.
Thank goodness for this blog and Dr. Amy, because if I hadn’t spent as much time here as I have, I could easily be in this mom’s shoes.

CSN0116

From the time I was a little girl I wanted five children. I am the oldest of four, profoundly comfortable with children and mothering, and “five” was just always my aim. I expressed this desire to my husband ON OUR FIRST DATE – ha. He didn’t run and married me less than a year later 😉

We wanted kids all close in age and thus in quick succession. We got lucky, the first month off of BC came mo-di twins; they were born before our first wedding anniversary. Early on in the pregnancy my OB discussed why he felt they were safest delivered via cesarean and I gladly consented while still in the 2nd trimester. He (the OB), knowing my desire for a large family, promised that we would aim for a VBAC in the future.

I waited 2.5 years in between deliveries and my OB and I patiently waited for spontaneous labor to begin with this hopeful VBAC baby. At 41+3 it didn’t come and he again felt safest proceeding with a repeat C. And so I gladly consented once again.

My third pregnancy/fourth baby was a very scary time. I had my OB’s blessing to attempt a VBA2C with strict rules. I knew that if it resulted in a repeat C that I would never have the five children I so desired. It was do or die time. I wanted it so badly (not the VBA2C, the ability to have more babies) but had prepared myself for the VERY STRONG, TOTALLY OVERWHELMING POSSIBILITY that it wouldn’t happen. My body had never even labored, yet alone gone through with a delivery free of any medical interference. But someway somehow it happened. And then it happened again with baby number five. I got to my five.

I share that to say that I get where you’re coming from. I had never been more scared or more anxious in my life. A third cesarean meant the end of a dream (for me), and that’s a hard pill to swallow. And it’s a good reason to “hate” cesareans. A VBAC (for me) wasn’t about feelings and empowerment, it was a mode to buy me the future that I wanted. Unlike you, I didn’t wait until I was OK with a failed outcome. I was never “at peace” with that as I waited for labor to begin. In my head it was more like, “hold my beer and watch this shit I’m about to attempt.” I just closed my eyes tight and went for it lol. I still think about who I’d be today, or how I would feel, if I had “had” to stop at four children. It’s fascinating to read your thoughts on it all. Thank you for posting 🙂

Karen in SC

Aren’t you a candidate for vba2c? In the States, many OBs will support you.

Azuran

But even if they do support VBA2C, if she qualifies for one and that she does want to try for one, Realistically, she still needs to be ready for the possibility of ending up with a C-section anyway.
You can’t just say ‘I’m doing a VBA2C’ and think that that’s what is going to happen.
No matter what, a c-section could always happen. If she is not ready for that, I think it’s good that she takes her time until she can make peace with this reality.

KeeperOfTheBooks

I’m not, at least not according to my OB, who does do a fair number of VBA2Cs. When he did the most recent C-section, he said, “I do not want you laboring with this uterus,” as it was pretty thin around the incision. I do plan on discussing things with him again before I get pregnant anyway, but given that he’s pretty VBA2C-friendly, it seems reasonable to assume that he wasn’t just saying that.

moto_librarian

Do you think that it would help to talk to your doc about the things that make the procedure and recovery so unpleasant? I know that there may be some things about it that you hate that can’t be changed, but maybe there are some small tweaks that would make it better for you?

KeeperOfTheBooks

I think what I hated the most about the procedure was that I felt like a slab of meat, not a patient or a mom. Lying on a table, naked from the chest down while a lot of people walked all around me, swabbed me with antiseptic, etc but no one even really acknowledged I was there, not so much as a “hey, how’re you doing?” or telling me before they started doing the scrub, like I was unconscious–but I wasn’t! No one talked to me, no one told me what was going on, and all the doc and his assistants did, aside from the warning about my uterus and having DH cut the cord, was discuss the recent basketball game and one of the assistant’s Ramadan fasting. :p I know that’s a good sign because it meant that everything was very routine, but from an emotional perspective, it made me feel like no one cared about me. At one point, I felt a little queasy, and I don’t know what they gave me, but it made everything kind of fuzzy. When they showed me DS, I felt nothing, like I’d gone in for surgery and then they randomly handed me this (admittedly, cute) baby.
Recovery I feel a bit more positive about. Next time, if there is one, I will insist on getting a 2-3 week Diflucan prescription to start a week or so prior to the CS which will hopefully knock out the yeast infection I always get around the incision before it can really start. Dealing with that for months afterwards, in addition to the two weeks of hives that I get after delivery, is just plain miserable.
I will be discussing this stuff with my OB before conceiving again, and see if he has any suggestions. I’ve toyed with the idea of hiring a doula for next time, if I can find one that isn’t neck-deep in woo, but they’re pricy around here, and dropping over a grand for someone to hang out with me for a couple of hours seems excessive.
Thanks for the kind words!

chloe b

I was told mine was thin around the incision. I got a second opinion in my next pregnancy and had an ultrasound done and sure enough it had healed very well. I went on to have a vba2c.

chloe b

If you have another baby after a 3rd c section your risk for acreta goes up to 1 in 50. If you are not planning on getting your tubes tied I would look into a vba2c.

Dr Kitty

OT:
I am seeing my doc in a few days because I have had four weeks of continuous bleeding since I stopped breastfeeding. As I have endometriosis this is double plus ungood, and I am having horrible pain.
It looks highly likely that I’m going to end up with a combined pill to control the bleeding while we make a decision about the next step.

I have a sneaky suspicion it’ll be a plan for laparoscopy + Mirena because I don’t want to induce menopause with medications and I’d prefer to preserve my fertility (DH would really like a third, I’m not totally adverse to the idea, but not immediately).

Ouch. Sorry to read this, Dr Kitty. Hope it works out, and the Mirena does good for you.

Dr Kitty

Here’s hoping.
The first one I had was awesome, the second had to be removed under sedation and both had to be put in under anaesthetic.

fiftyfifty1

ouch. good luck!

BeatriceC

Hugs! That sounds miserable. Here’s hoping the plan works wonders for you!

Gene

I had the old Norplant (showing my age). And bleed 2/4 weeks. Very annoying. Mirena, though, kicks ass. I went from 7-8 days of very heavy periods (tmi not included) to maybe some light spotting on one day every month. No pain. It rocks!

Jessica

I’m sorry you’re going through this – I’m dealing with something similar. I am still breastfeeding, but I have more or less been bleeding continuously for the last month as well, and I have Mirena. It was inserted at 12w postpartum and I had only minimal post-insertion spotting, my period returned at 4mos postpartum and was a bit irregular. At 8mos postpartum all hell broke loose – I think I’m having 21 day cycles but I can’t tell because there’s so much spotting in between, and on the heavy days the clots are unbelievable. My first experience with Mirena was much better.

Chant de la Mer

That really sucks, I hope the Mirena helps. I know you had it in the past and switched but I hope it works out for you this time and doesn’t cause more trouble. Endometriosis is terrible, I don’t have it but I’ve heard so many stories from others about it that you have my sympathy.

This illustrates the tremendous harm that comes from the drive to reduce cesarean rates that some have capitalized upon to drive women towards midwives/NCB/etc. When cesareans are portrayed as evil, or things “to be avoided” – a la consumer reports, women become hesitant to accept sound medical advice. This is devastating for any woman to contend with – and if, cesareans were viewed as “just another way to have a baby” with risks and benefits and counselling was a little more the benefits AND risks of vaginal delivery for you, the benefits AND risks of cesareans for you – and a little less the benefits of vaginal delivery and the risks of cesarean generally – situations like this might happen a whole lot less. The drive to reduce cesareans will have negative, unintended but significant consequences – it will come with collateral damage, much of which will be borne silently.

Anna

Totally agree. And women must not be egged on to ignore medical advice. Never. Anyway it’s funny how much mass media influences us in these things. Somewhere in Brazil or China they think VB “is for the poor”. In the western countries nowadays all c-sections “are unnecessary”. God, we do need to develop a sensible approach! It’s not a question like what hair color is fashionable this season.

CanDoc

This situation is tragic, interesting, and complicated. It is not necessarily as clear as it sounds.
The best research and clinical practice guidelines still suggest that low risk women should be routinely offered induction of labour at 41-41+3 weeks to decrease the risk of stillbirth and cesarean section. Historically, otherwise low risk women who wanted a VBAC were offered repeat cesarean section or cautious induction of labour at 41-41+3 weeks or beyond. (The 41 to 41+3 is based on the massive post-term study, that showed risk of stillbirth rises dramatically after 41+3).
However, research out of Ireland was performed to explore why women with a prior cesarean section had an increased risk of stillbirth, and when they reviewed their data it became clear that a large proportion of women with prior CS who had a stillbirth presented with intrauterine fetal death while “waiting for their VBAC”, i.e. between 39 weeks (typical date for repeat CS) and 41-42 weeks, when they would be booked for induction or repeat CS.
This hasn’t translated into a clinical practice guideline yet about fetal surveillance. We know that with a normal biophysical profile, risk of stillbirth is about 1-2/1000 within the subsequent 7 days. So in light of that, this woman was profoundly unlucky.
In my practice we review the data and offer women VBAC if they are interested, with a view to repeat CS anytime between 39 and 41 weeks that they are comfortable with. The occasional woman prefers to avoid induction, so we ramp up surveillance at 41 weeks and strongly recommend repeat CS by 42 weeks at the latest.
So if she was otherwise low risk, this woman wasn’t entirely eschewing common practice by awaiting labour as long as 41 weeks – although obviously had a lot of issues in her relationship with her care providers. It’s hard to know what other issues may have contributed (such as pregnancy complications or other medical/surgical history).
So, as much as I find the attitude of the online cheering squad reprehensible (“Good for you for standing your ground!”, “… unnecessary surgery… losing money…” etc), my heart is just broken for this mom whose arms are empty tonight.

PrimaryCareDoc

The full thread had more information. The baby’s heart rate was high and the doctor and nurses were concerned. She also had high blood pressure.

Amy Tuteur, MD

It appears that she wasn’t low risk. She doctor-shopped until she found someone willing to supervise her VBAC but only under specific conditions, which she violated. She had her original C-section because of a Bandl’s ring.

In other words, no the doctors weren’t insisting on a c-section for no reason….

CanDoc

Wow. The whole industry – doulas, crowdsourcing groups – are covered in blood when things like this happen. 🙁
(I am intellectually interested/surprised that she had a VBAC (in spite of the tragic outcome) after a Bandl’s ring.)

Cody

A doula following an appropriate scope of practice does not give medical advice. If there was a doula involved, all she should have been doing is encouraging conversation between the doctor and patient. What we are supposed to do in this type of situation is help brainstorm questions for the care provider, not recommend VBAC, or anything else of the sort. I wish there was more oversight in our industry because doulas can be a great help when they act appropriately.

If you find that a doula is crossing a line, there are remedies, and in some extreme cases, individuals are told they aren’t allowed at certain hospitals.

If this woman doctor-shopped then there is also an OB out there who presumably did not act in accordance with responsible guidelines. When many OBs in any given area give different recommendation based on the same guidelines, it gets very difficult and confusing for some patients.

I’m not trying to deflect from the responsibilty of this VBAC group. It sounds like they really overstepped some boundaries.

yugaya

Whoa.

Cody

I didn’t read her online comment until after my comment below.

From the sounds of it, the doula was actually speaking to the doctor on her clients behalf. That’s a big no no. It’s not that we can’t speak to doctors but we really aren’t supposed to advocate on behalf of the patient. That’s really dangerous.

Roadstergal

But hey, you can fix a Bandl’s Ring with red raspberry tea and chiropractic!

I am in tears reading this. The poor baby and the poor woman. Being tricked and flattered into thinking you are extra special and educated and independent is not a crime that deserves a punishment of the loss of your baby. Nothing is.

I am typing this from an antenatal ward where my boring-as-anything textbook average blood pressure for the past 36 weeks has suddenly shot sky-high and my baby is showing signs of IUGR. The doctors can do WHATEVER they want to me to keep us both in the best of health but above all else to keep my baby safe and alive. I am anxious throughout pregnancy anyway but right now, the worry is all consuming, balanced only by the reassurance that this building and the people who work in it and the technology they use is geared in every way to my baby and my best interests. Induction, bed rest, section, more blood tests, more whatever’s, whatever the heck they suggest, I am doing it. And I am grateful that I have that chance.

But I know how alluring it can feel if an instant Internet fan club cajoles and flatters and brainwashes and above all else, tells you this choice is best for your baby. That is so much what any of us want to hear.

Empress of the Iguana People

Good luck! i had to get induced with the heir apparent at 38 weeks because of BP.

Megan

Hope everything goes great for you and baby. I always have trouble with my blood pressure at the end of my pregnancies and I have delivered both my babies barely at term because of it. It causes such anxiety! Good luck!

Amazed

Good luck to you! May you have your little or not so little little one just in the right time and safely.

Mishimoo

Good luck! Hope everything works out okay and that you get to safely snuggle your bub whenever they arrive.

Felicitasz

Thinking of you. Good luck, I hope all goes well.

Montserrat Blanco

Best wishes! If you need tips or anything from a former NICU mom let me know.

MI Dawn

Good luck to you! Missed this post, but my kids were induced at 37 and 36 weeks due to BP issues. They were fine.

BeatriceC

OT: can y’all help me help a friend? She’s a bit frustrated because her three month old has pretty bad reflux. Her doctor won’t prescribe anything because he says there’s a lot of evidence that medications don’t work. He doesn’t sleep well because of fairly frequent gagging, and my friend is exhausted. Is her doctor correct? Most of what I can find is hidden behind paywalls, so I’m not sure what the data really says.

So I am not a medical expert by any means, but getting a second opinion never hurts. And between the bad reflux and the odd headshape, I think it’s completely justified.

Kelly

Plus, she would feel better if two doctors were in agreement.

mythsayer

Ummmmm….that kid needs an X-ray of his head. He could have a mild form of craniosynostosis

BeatriceC

My initial response was that I’d want a specialist to evaluate that. I’m not at all well versed on the possible outcomes and ranges of normal with this sort of stuff. I didn’t want to overly freak out though.

sdsures

Have they checked him for hydrocephalus? (I was a preemie and I have it.)

fiftyfifty1

You can’t tell about the head from a picture. At this angle, it looks fine to me, very similar to what one of my own kids had and not something that I, as a doctor, would treat. But like I said, you really can’t tell from a picture. Get a second opinion.

Likewise with the crying and gagging. One of my kids was a fussy “colicky” kid, who also had a very strong gag reflex and vomited *a lot*. But since kid was growing well and meeting milestones, we decided not to try a medication. Baby “reflux” is very over-diagnosed and meds are very over-prescribed. On the other hand, the meds are fairly low risk, and each kid is different. Get a second opinion.

BeatriceC

Thank you. That’s basically where I’m at. I do believe the child actually has reflux from everything that’s going on. The poor kid gags himself awake hourly at least during the night. He’s doing a little bit better with some changes she made to her own diet, but not a whole lot.

I just couldn’t find any literature regarding meds and reflux, and wanted to make sure I wasn’t overreacting to either that or the head shape thing (and yeah, I know the angle is bad…he’s a wiggle worm and she was having trouble getting a good one to show me) by urging her to get a second opinion.

Megan

Re: the GERD, my 9 month old had horrible reflux that did cause poor weight gain. We tried Zantac and that seemed to make her worse (I think because of the absolutely foul taste) and I did not want to put her on a PPI (like Prilosec, for example) if I could avoid it. Thickened feeds didn’t help either. Changing her to Alimentum did help but she had obvious signs of a dairy allergy (hives) and even after that she still spit up a lot. We’re talking changing clothes 5-6 times a day and projectile vomiting entire bottles. There were days I literally was in tears trying to get her to keep down any of her formula and many times I thought we’d be better off just sitting in the bathtub naked to feed her all day. We went through a lot of burp cloths and a lot of laundry detergent! Your friend’s doctor is right that overall, meds are overprescribed and not all that effective. Usually they are reserved for kids that are not gaining weight (or losing it). That being said, as a mom, I can totally relate with how incredibly frustrating having a GERD baby is. I really do feel like there should be “GERD Survivors’ Club” T-shirts or something! In our textbooks, pediatric GERD is always described as “a laundry problem” which makes it sound like no big deal, and often it does resolve on its own with little consequence, but that doesn’t make you feel any better when you’re in the midst of dealing with it! The only thing that helped my daughter was time. Right around 7 months, it magically just stopped. I’m so glad we are past it. Best of luck to your friend. I don’t think it ever hurts to get a second opinion if she is concerned though.

BeatriceC

Thanks for replying. He’s completely EBF straight from the tap (now anyway…there were some supply issues at the very beginning and she supplemented with formula for a couple weeks), and changing her own diet did help a tad, but not much. And he’s a peanut. He was 6 pounds even at birth and has been gaining okay, but still staying tiny. Of course, she’s tiny, so that’s not entirely surprising.

Megan

Also, one thing that helped us at night was to have her sleep in her swing with a slight incline. Obviously, if your friend’s daughter is rolling over, that’s not a great option, but if she’s still not that mobile, perhaps that might help?

CSN0116

I would definitely get that head evaluated.

I skipped the meds (they worked for literally nobody I knew, have to be readjusted constantly with weight gain, blah) and used thickened feeds with elevated belly sleeping. No idea how a from the tap kid could do thickened feeds, and breast milk requires special thickening agents as it dissolves rice or oatmeal in mere minutes. But my bub was eff and his symptoms stopped after the first thickened feed! It was miraculous after weeks of vomiting and fussiness.

Allie

My LO spit up constantly until she was about 8 months or so. I don’t believe it was actually acid reflux. The milk that would come up usually wasn’t curdled and there was no acid smell. But, we gave her the medication for a while anyway, as the doctor said it wouldn’t do any harm. I never found it particularly effective. The only thing that helped a little was to keep her upright and still for as long as possible after a feeding. Ultimately, I just accepted the situation and waited it out. I remember one particularly bad day when she was only a month old at the most, I went through eleven t-shirts in a single day (just during the day, not counting overnight!) It was fun : )
Can’t really offer an opinion on the head issue. From what I can see of him, he’s cute as a button, though.

This is my local Infant Feeding Guideline- evidence based, no pay wall and although designed for HCPs it is flow chart based and quite easy to understand.

Personally, for GOR I do positioning-> thickener-> PPI (with trial of dairy-free diet or hydrolysed formula if evidence suggests CMPI). Most of them still puke regardless.

They all grow out of it eventually, and starting solids at 4-5 months can help.

For breast fed babies PPI is by far the easiest treatment option. It is once daily dosage of 1mg/kg omeprazole- which is easier than ranitidine (twice daily dosage which has to be increased frequently with weight gain) or thickeners (which have to be mixed with EBM and spooned or syringed into the baby after every feed).

Any way- hope your friend finds something that helps, and I’d get a second opinion if I were her.

EK

He will probably grow out of it. My baby’s was worse and now his head is normal shaped.

Also my baby had reflux really bad and we switched formulas to Humana for Acid Reflux. It works great. It is very foamy and kind of weird but it completely stopped the vomiting and now he only cries when he’s hungry or tired which is such a relief because before he would cry for up to five hours and nothing could soothe him.

Good luck. Reflux is a bitch.

Marylynn

Hi there. I had a reflux baby that really suffered. He’s finally off medication at almost three years old. I highly suggest your friend join the Facebook group Reflux Rebels. It helped me a ton. I wish I knew a way to contact you without putting up my email on this site. If you can figure out a way, I’d be happy to tell you the things that worked for me and my son.

He slept on his stomach from week 2, FWIW. He was sleeping 12 hour nights by 12 weeks because of this. It was the only way he could sleep. My friend’s reflux baby slept on his back and choked on his reflux. His parents heard him choking on the monitor and by the time they got to him he was gray and unresponsive. Luckily, they got him breathing again and he was ok, but it reaffirmed my decision to have my son stomach sleep. Plus my son’s head shape was perfect. Not a decision I made lightly, and I had a Snuza breathing monitor on him because I was paranoid, but it worked for us.

guest

My 2 both had reflux and cried all the time, which to me was worse than the spitting up. Both had the medicine and within 3 days were completely new babies, happy and sleeping well. We tried positioning and thickeners before moving to medicine. I would say get a second opinion and at least try the medicine, if it doesn’t work, it can be stopped. My 2 were gaining weight but I was concerned with the lack of sleep they were getting, I just didn’t think it could be good for brain development. My oldest has asthma like symptoms that his doctor suspects may be silent reflux, but he seems to be outgrowing it thankfully. As for the head shape, we saw a specialist for our oldest that was very helpful in giving us the odds it would correct itself and how long it would take. We ultimately did the helmet because insurance covered it and as a boy, he would probably have less hair to cover it up. The helmet was more stress in theory than actuality. My son could have cared less he had it on and we got used to it quickly. He wore it for 6 months during the time he was first getting mobile and it was off before a year.

swbarnes2

Is this really a VBAC gone wrong story, or a “My baby is a special snowflake, and due dates don’t bother us” story? It’s not clear to me how ill-advised waiting till week 41 was for this patient, how big a risk she was taking. Are there more risks to being overdue after a previous C-section?

Sarah

There are more risks to being overdue full stop.

Kris

Yes. People don’t seem to get that the placenta, amazing organ that it is, evolved to work for a specific period of time and then stop working. After that, you’re rolling some serious odds on infarctions and/or calcification, along with the other risks, which go up precipitously at about nine days overdue (but I wouldn’t go to nine).

KeeperOfTheBooks

Yup. 41 weeks was my personal limit, and we opted for a CS at 40w5d because while I adore my OB, I loathe one of his partners and absolutely did not want to risk having him do the CS. (The one time I had contact with this partner, he was on call the weekend following my first CS. When I reported that the area around my incision was swollen and dark red with red streaks extending out from it, he said he couldn’t remember if the medication he wanted to prescribe was prescription-only or not, and could I check for him?, and then when I did check, he never called in the script. Lastly, it sounded like he was at a party when he called me back, and I could be being paranoid, but he sounded like he’d had a couple of drinks.)

Kris

Could you check something that I should already know? I’m busy drinking and I’m sure the infection you’re working on will keep until tomorrow.

What a piece of work. I grew up with doctors, and there seem to be a lot of drinkers among them, although I don’t think I’ve ever met one who drank while on call.

momofone

My son and I had ABO incompatibility. When I went for my ten-day checkup after my c-section, I had to see the partner I can’t tolerate. As I was asking him questions, he started drawing something that even I knew had no relationship to what I was asking. When I pressed him, he said, “You know, I really don’t like to memorize things. You should probably just look it up.” Ok then.

chloe b

An ultrasound should be able to detect placental calcification.

Kris

An ultrasound is looking at limited chunks of the placenta from certain angles. It can’t detect calcifications that are not obvious on the surface, and it can’t detect infarctions that could cause acute distress and death. You can’t even reliably see cord knots in an ultrasound. The only thing it can do reliably is measure fluid levels, which are important, but not the only critical metric by any stretch.

chloe b

Not even with a color doppler ultrasound? I am not a doctor but this is what I read online. Correct me if I am wrong.

fiftyfifty1

Kris is right. When placentas are evaluated they are evaluated using doppler ultrasounds, but even so, what they can pick up is limited.

fiftyfifty1

It CAN detect them, but it can also miss them. Ultrasounds, whether doppler or not, are imperfect tools.

MaineJen

A poster downstream commented that this mom was also having major blood pressure issues, and clearly (to anyone with a brain, anyway) needed to be delivered asap. Hence the worried calls from her providers.

I would love to know if the group was “supporting” her in ignoring her BP readings, too.

Erin

I think the problem is that you tend to mostly find cheer-leading like that in vbac groups. By the sound of it, it wasn’t a problem caused by her previous section but had her “support” network been singing from a different hymn book the outcome could have been very different.

Melaniexxxx

I reckon she was probably being supported to VBAC as it’s not uncommon these days but then got ‘risked out’ and recommended CS when she went post-dates.

Lurkerette

If the OB is like my sister’s (who is considering VBAC but open to a scheduled section), s/he may enforce a “VBAC, but only if labor starts spontaneously”, i.e., no induction. So she may have been waiting and going no-contact to avoid being told she couldn’t wait for spontaneous labor.

Amazed

Poor baby girl!

That sick mindset took another victim. Those assholes must have been priestess of Baal in a past life. Or some other god demanding child sacrifices.

sdsures

This is unconscionable behaviour for a parent. Would we let parents get away with abusing a live baby? This child was presumably wanted and could have lived outside the womb because of her advanced gestational age, no?

I’m pro-choice, and I feel that this mother killed her full-term baby almost maliciously.

AnnaPDE

Yep, the same mums would probably be terrified to let a one year old travel in a forward facing child seat, or a five year old ride a scooter without a helmet in a park. Same with eating cheese before birth. That would make them look like they aren’t doing everything for their child’s safety.
Actively endangering the kid’s life because they want to be a birth warrior, on the other hand, seems perfectly fine.

sdsures

Cheese?

AnnaPDE

Sure. The paranoia has spread from unpasteurized milk cheese to pasteurized camembert and from there to all kinds of cheese. After all, Listeria are sometimes found in pre-packed kinds of hard cheese, so anyone even thinking of so much as looking at a cheese sandwich in pregnancy is an irresponsible baby murderer. At least judging from mommy forums.
As you might imagine, I stopped googling pregnancy related stuff quickly.

Azuran

The paranoia is just everywhere. Don’t even get me started on trying to figure out whether I should be standing up, sitting or laying down (BUT NOT ON MY BACK) Because too much or too little of everything is bad for you and the baby, BUT don’t change position too often either, because that’s bad too.

sdsures

Yeah – googling everything would drive me nuts. The one thing I do look for on the internet is blog posts written by people with the same medical problems I have, to see what I can do to prepare for things that may come up during pregnancy and raising kids. A lot of people with physical disabilities have to work things out by themselves in terms of adaptive equipment for baby care, or doing things a bit differently. e.g. http://www.bbc.co.uk/blogs/ouch/2013/03/im_a_crawling_mummy_how_one_di.html

I have a sneaking suspicion that it might be illegal (or at least highly unethical) for them to panhandle like this while waiting for insurance payments. When you contract with an insurer, you get what you get and you don’t get upset. You don’t get to collect extra, above and beyond payment, because you can’t manage your finances. I deal with it all the time in my practice. You don’t want to deal with it, go cash-only.

Concerned Anon

I believe that is only the case when you are contracted (or “in-network”). This is likely their last ditch effort before closing their doors. Oregon may lose Alma and Andaluz both this year.

AA

I wonder if they are getting Medicaid claim denials for their patients:

Do Alma midwives attend breeches or twins?
The short answer for that is that it depends. We are
allowed to attend those births at home but not at the birth center.
Because twins and breeches present an elevated risk, we evaluate those
births on a case-by-case basis, and we’ll make a plan together with you
about whether home is the best place to have your baby (or babies).”

These people are so reckless.

Amazed

I’ll never stop wondering at the logic of mothers who think that with certain risk conditions contraindicated for a CENTRE, it’s all fine and dandy to give birth home where LESS interventions are available. How can they trust providers who ignore safety so blatantly?

Azuran

Probably because they tell them that it’s not about safety, it’s just big bad doctors who pushed to make it illegal in birth center to make more money.

Amazed

The same thought came to me. Still, I can’t believe there are women who are so criminally stupid – and I mean criminally. I’ve said it before but there is a place where my sympathy ends and pure disgust begins. That would be one of those places. One had to be particularly dumb-dumber-dumbest-homebirth with such risks-dumb to place their trust to the lower-level care providers to such an extent.

DelphiniumFalcon

Maybe they should ask Vickie Sorensen how attending twin births worked out for her.

“Hire an independent/homebirth midwife – you can privately hire your own
independent midwife who will support you as a doula would, but with more
extensive training. I believe independent midwives are the gold
standard in maternity care for low risk women. At less than 1%, I think
you’re low risk for uterine rupture. Thats more than 99% that says you
will be perfectly fine. ” Brilliance /sarcasm

MaineJen

“I can tell this without seeing you in person or knowing anything about your case, because special magic sparkles.”

This is heartbreaking. That poor baby. That poor family. I feel so sad for them 🙁 Sad doesn’t seem like a strong enough word, but words are failing me right now.

While of course we all hope members of the VBAC group will reconsider their position, first and foremost I grieve that this happened at all.

Cyndi

You are a much better person than I. All I can feel is anger. Anger that this baby would have lived if the mother hadn’t had the immense hubris she demonstrates, anger that this appears to have been a healthy, normal baby until mom killed it, anger that mom’s echo chamber cheered her on. As with so many other examples of anti-science parents, they feel they have triumphed at the expense of an innocent child.

Ash101

I don’t see her “triumphing” in her final post. If she was brashly celebrating her VBAC, I’d be angry. We’ve seen plenty of examples of NCBers undaunted by the death of their own babies. But I don’t see that kind of statement here. Rather, I see shock and grief.

Furthermore, I think that the mom was inundated by tremendous pressure from her peer group and targeted by an exploitive, cultish, profiteering “movement” (NCB). Obviously, this peer group was self-selected. She certainly bears responsibility for choosing to associate with and listen to them rather than her doctors. But so does every single member of that group who blithely cheered her on without once considering the potential consequences. And so does every leader of the VBAC/NCB movement. As a general rule, I feel sorrow for the victims of cults and anger towards the leaders of them.

Heidi_storage

Yeah, I agree with Ash. This mom was dumb, dumb, dumb, dumb to listen to all of the yay-VBAC-boo-doctors nonsense, but she paid a really terrible price for her stupidity. (Not as high a price as the baby, of course.) If she starts talking crap about how this was her baby’s “journey” or some such nonsense, I’ll change my opinion, but right now I mostly feel sorry for her and for her family.

namaste863

Damn it straight to hell. For the millionth time……….c sec or vag. WHO. GIVES. A. FLYING. FUCK?!!! By agreeing to carry a child to term you have tacitly accepted responsibility for their health and welfare. That means doing whatever the fuck it takes to get them out alive. If that means enduring something you don’t want to avoid harm coming to them, so fucking be it. That’s called being a grown up, not an entitled, whiny, overgrown adolescent. If you have a bad experience, yeah, it sucks. Tough shit. Get therapy.

AnnaPDE

Yeah, this. There are wants and needs and you can acknowledge the former while still going with the latter.
When my mum sort of went into labour with me but it wasn’t really going anywhere, her doctor explained to her that they’ll need to get me out via CS and it would be a good idea to do it now (at 4 pm) when things are still looking good, as opposed to waiting until it’s a real emergency at presumably 4 am, fully staffed hospital, rested doctors and all that. He concluded with, “So, are you happy with that plan?” Mum: “No, not happy at all.” Doc: “But, …” Mum: “Of course, let’s do it straight away, after all it’s necessary, I just don’t want to pretend I’m happy about it.”

Kelly

I like your Mum.

Krystle Dolbow

Haven’t read the comments yet so I’m not sure if this was mentioned, but I was informed that she was having serious blood pressure issues which is why even the clinic director called her. They were worried. Baby was alive and well the whole day that she was supposed to have her csection so regardless of the cause of death, it’s a completely preventable death. So sad. It really bothers me that these people cheer these women on to do dangerous things and whenever a voice of reason speaks up, she’s dog piled on and deleted for “fear mongering” and being “unsupportive”. At first, I thought the one admin had potential to change everything and prevent this from happening again. That changed when she started banning everyone that’s also in the evidence based group that was talking about it. Some were even preemptively banned. That admin is also in the EB group but never responded once to those who tagged her. Even Ashley, the admin from the vbac group that most recently imploded when she had a change of heart after a few deaths each within a few weeks of each other, commented saying that she was willing to talk to her because she’s in over her head. If course, it didn’t happen. She made the group secret which, in a way, is good because less women will find it.

MaineJen

Denial is a hell of a drug…

MaineJen

How long until this is deleted from the “support” page?

Or has it already been deleted?

AA

Somewhat off topic, I suppose, but “agreed to give me an epidural even though they usually don’t do epidural for vbac here.”

What would be the clinical rationale for that?

Kris

This is just a guess, but there are some docs who only do VBACs under very specific circumstances. Many won’t use pit, at any level, because of the fear of rupture. It may be the hospital has that policy because they are trying to discourage VBACs, or because of the few risks involved in epidurals (blood pressure issues, usually minor and manageable), or it could be that she misunderstood. I’m guessing she wasn’t thinking clearly at that point (or, it could be argued, during this whole pregnancy).

Azuran

If anything, it would make sense for someone with a vbac to have an epidural already in place. That way, you can do a crash c-section at any time. But I’m not an OB, maybe it increase the risks of some complication during a VBAC? Maybe it was some other reason.

Kris

That’s true, but a spinal is very quick, and they often go with that option for c-section instead (if it’s a crash, they often choose a general). I don’t know if any increased risks for VBAC patients with epidurals, but I’m not a doctor either. 😉

Puffin

Guessing (becaus epis are allowed for VBAC here so I’m not familiar with this approach) but perhaps it has to do with disproportionate pain or atypical pain being one of the signs of rupture.

Mom of 3

I was an OB nurse for 4 years and I have heard the rationale that if the uterus ruptures, if the patient can feel it it can be diagnosed faster. But a doc I worked with told us that was outdated info, because pain level isn’t a reliable indicator of rupture, fetal monitoring is much more reliable (and fetal monitors work better on patients who are holding still, which is much more likely with an epidural). It’s also obviously cruel. We always did epidurals for VBAC. So if docs are really practicing that way where this patient is, that’s honestly a little scary to me.

“Donald Trump’s pick to lead the Department of Health and Human Services is a member of a far-right medical group that peddles conspiracy theories, and has ties to an anti-health care reform activist infamous for sharing a racist image of President Obama on a Tea Party email listserv.

“Rep. Tom Price (R-GA), an orthopedic surgeon, has been repeatedly touted as a member of the Association of American Physicians and Surgeons (AAPS). AAPS, established in 1943, aims ‘to fight socialized medicine and to fight the government takeover of medicine’ and in its statement of principles urges members to refuse to treat Medicare patients, reasoning government involvement in healthcare is ‘evil’ and ‘immoral.’ The group also rejects required vaccination programs in schools.”

New Mom

Wow. That’s horrible.

Making laws restricting access to abortions, birth control and other health care somehow doesn’t count as government interfering with medicine because…?

I guess that’s when they start screaming about some conspiracy theory.

I’m trying to wrap my head around that bullshit.

Isilzha

“let baby choose the day”

See…it’s not her fault! The baby screwed this up by not knowing when to be born.

moto_librarian

If anyone who cheered on this risky decision parachutes in, it had best be to apologize for the death of this baby. Every single one of you who encouraged this mother to ignore medical advice, to trust her body, who resorted to outright lies about why the doctor wanted her to have a c-section (I’m talking to you, H, “Of course they called … they are losing money if you don’t submit to unnecessary surgery.”), each one of you is partially accountable for this. Jen Kamel, you are also responsible for this because of your continual campaign of misinformation about the real risks of VBACs. Does the money that you make from your seminars allow you to sleep at night? The mother bears some responsibility in this as well, but never doubt that all of you who cheered this on are culpable as well. You should all be deeply ashamed.

Madtowngirl

Take a look at the GoFundMe page. She’s received all of 4 donations. Where’s all that support for her now, VBAC group?

moto_librarian

She will now be shunned for having a bad outcome. I guess it must be difficult to acknowledge that your idiotic cheerleading played a role in the death of an otherwise perfect baby. Rather than begging for forgiveness, they just close ranks and pretend that it will never happen to them.

Sin_dorella

That GFM is set up by the admin of the group that cheered her on, too. No way I would donate money to the women who facilitated the advice that led to her baby’s death.

Allie

Agreed, except I would take out “partially.” In my view, accountability isn’t a finite quantity, and each of them is wholly responsible.

Platos_Redhaired_Stepchild

They would be ashamed if they were capable of normal human emotion.

Heidi

So horrible! I wish these “supportive” people could understand how ignorant they truly are. Google doesn’t make you a doctor! Vaginal births are painful and require recovery, too. I can understand hoping for a vaginal birth over a c section, but vaginal births aren’t magical! They aren’t worth going against prudent medical advice. Once the 2+ months long pain subsided, I have never again thought about my baby exiting my vagina. If you are reading my comment and are considering a VBAC against medical advice, vaginal birth is merely a way to get the baby out. There are no sparkles and magic. There’s blood, sweat, tears (the cry kind and the rip kind), and feces, though.

Kris

I’ve been a doula for 14 years. I still can’t understand, at all, why anyone thinks that their longing for a certain kind of birth experience (like vaginal birth is so magically enjoyable for everyone) outweighs the health of their baby. Real, valid concerns for the baby’s health. I’ve done my best to fight against that, and I won’t take clients who are going against medical advice. I just don’t get it

BeatriceC

We need your doulas like you.

Kris

Thanks. I’m a firm believer that some outside support is helpful for most women during labor. However, a number of people in my line of work also subscribe to a lot of woo, ignore scientific evidence, and place “feelings” over facts.

David N. Andrews MEd, CPSE

You’d be the first ever evidence-based doula that I’ve ever encountered.

BeatriceC is absolutely right.

Dr Kitty

Completely OT

David, I wonder what you think about the fact that my local paediatric “Autism Intervention Service” actually doesn’t usually see autistic children themselves?

Parents complete a questionnaire about their concerns and their assessments of the child’s problems, and then the parents are invited to attend parenting workshops and seminars to improve their parenting skills- the “intervention” is for the parents, not the children.

Personally, I’m not impressed, but I wondered what you thought.

David N. Andrews MEd, CPSE

WTF?

I’d want to see the child AND the parents – usually together and usually in situ, wherever the referral problem arises!

Improving parenting skills is all very well but it’s imperative to see what the results are, to make sure that the parents are doing everything right. Can only do that if the children are there too.

Thanks- my suspicion is that it is the cheapest, easiest way they can provide a service with minimal staffing by the least qualified people allowable.

I only discovered this recently, when the AIS asked me to see and assess a child with a view to onward referral and I asked why they couldn’t do it themselves, given the child was on their books.

At which point I was informed not only had the team never met the child and wasn’t planning to, but that no one on the team was qualified to make the necessary referral.

I may have used unladylike language at that point.

David N. Andrews MEd, CPSE

The idea of unladylike language makes me smile!

I’d love to see their website …

Dr Kitty

Completely Off Topic (and I’m sorry if this is a double post)

David, I wonder what your thoughts are on my local paediatric Autism Intervention Service, which doesn’t see the autistic children and young people, but rather relies on questionnaires completed by their parents, and then offers “intervention” by sending the parents on parenting courses and seminars with titles like “managing angry outbursts in autism”.

Keep in mind that a doula shouldn’t be giving much advice in the first place. “Evidence based” almost becomes a moot point when we practice properly

We should be giving this type of advice; breathe with me during the next contraction; write that down on your list of concerns that you’ll discuss with your car provider; you should make that birth plan shorter and discuss the items on it with your care provider; (name of father), remember your camera when they call you in for the c-section, and many more. I don’t really need evidence to back up that type of stuff.

David N. Andrews MEd, CPSE

Well, not for that stuff, but to make it clear why a lot of ‘available practices’ are bollocks … an evidence-base might be a bit useful for that. 😉

Cody

Agreed. My most recent client asked me for referrals for placenta encapsulation. Even after I provided good literature debunking the whole thing, she still wanted to do it. Sigh.

David N. Andrews MEd, CPSE

I’d just tell the client that she can’t have it because the law requires that all placentae are state/crown property and therefore required for the manufacture of royal dog food! 😉

Bugsy

“Keep in mind that a doula shouldn’t be giving much advice in the first place.”

Wish the one doula we’d interviewed when I was pregnant with our first son knew this. Her woo-based advice was so heavy during the interview that we turned away 100% from the very notion of having a doula. Advice such as “You should avoid the vaseline they smear in the baby’s eyes after he is born; it’s completely unnecessary and has no medical purpose.”

Our son proudly got his antibiotic eyecream the morning of his doula-free birth.

Cody

She was out of scope, whether or not she agrees/disagrees with it doesn’t even matter.

Bugsy

I wish I could have hired you as my doula!

Cody

Thanks!

Kris

That makes me sad. I hope you run into a few more at least.

BeatriceC

I think about my 17 year old’s vaginal birth every time I sneeze, cough, run, jump, or laugh too hard. Maybe not every time, but I do think about it. Stress incontinence is the pits.

Heidi

Yeah. I had one of the more ideal outcomes of a vaginal birth. Tears that only needed stitches and didn’t result in long-term damage, or at least so far. Who knows exactly what the future holds, though? I don’t think it’s unheard to experience pelvic floor collapse and/or incontinence later in life from childbirth. I know I was in a lot of pain, so much so that I kind of just wanted to die when the contractions set in. It hurt so badly that I can’t even fathom how much it hurt today. I know I was also really worried and depressed about my tears when they didn’t magically heal in 6 weeks, but since it was traumatic to me at the time, I think I’ve just blocked the experience and don’t give it any thought anymore now that the reminders are gone.

BeatriceC

OK had a mild to moderate SD that was worse than it had to be because of incompetent nurses (they should have alerted the doctor before they did and allowed me to push for too long). The doc cut a 3rd degree episiotomy because I started to tear and he was trying to minimize the damage and still get the baby out as fast as possible. I actually had my perineum re-tear a number of years ago along the scar from that. That was all kinds of fun, let me tell you.

Give me the little flap over my CS scars any day of the week over this. That’s the only long term effect of my CS deliveries.

Bugsy

…or when I jump on a trampoline with my preschooler.

chloe b

Only vaginal birth doesn’t come with the risk of placenta accreta. The rate of secondary infertility after a c section is also double that of a vaginal birth when all factors such as maternal age and post birth infection are controlled for.

Heidi

Yes, I’ve seen you numerous times make this comment on a 2 year old post. This is about going against medical advice, though. And going against medical advice resulted in a dead baby.

Azuran

I’m sure that though made her feel so much better as she buried her dead baby.

Who?

I don’t understand how someone can risk one baby’s life now on the basis that if they don’t, future babies may be at risk.

Isn’t there a saying about the value of the bird in the hand?

Azuran

Me neither.
Sure, I want multiple kids, but when lots of things started going south, what mattered was the baby I was carrying right now, not hypothetical future babies. I needed a c-section and that was it, and I’m not interested in a VBAC. If at some point, having many c-sections results in me not being able to have children anymore, I’m fine with this, I’d rather have only my current healthy child than not having her and maybe have 4 hypothetical ones down the line.

Who?

I feel the same way. Also, every day you live to fight, doctors get better at what they do. So just because something isn’t recommended now, in five years people know more and might be able to find a way to change that.

rational thinker

I think there is some kind of thought process with a lot of these vbac people that is if you don’t give birth vaginally then you did not give birth, and somehow you are less of a woman for it. Some of those feelings get carried over to exclusive breastfeeding as well, and babies will and have paid the price for both ideologies.

Sarah

Is there a reason you’ve only mentioned one issue when sections and vaginal birth attempts both come with a number of risks and benefits relative to each other?

chloe b

At the end of the day it depends on the wishes of each individual woman. I don’t want any more c sections because I want a large family. I had a vba2c in a well equipped hospital and it went very well. I even had my scar measured via ultrasound to estimate my rupture risk. If a woman wants a smaller family then having c sections isn’t usually a complicated issue.

fiftyfifty1

I agree. That’s why it’s important for all the risks of both CS and vaginal birth to be presented free of bias. Then a woman can decide which ones are most relevant to HER. The majority of women do not choose to try for large families, so for them the health of this current pregnancy is most important. But for a woman who wants a large family, putting this current pregnancy at slightly increased risk may be a reasonable trade off for better odds of health in the future for mother and potential siblings.

There is another semi-regular commenter on here who also chose a hospital vba2c (or maybe it was even a vba3c.) She wanted a large family, and in other ways she was an excellent candidate as the first CSs had not been due to stuck babies, but rather random factors. She looked at the risks with open eyes, and decided it was worth it for her. Since she was higher risk, and knew it, she was really careful to follow her doc’s recommendations about monitoring etc. It ended up great for her. Nobody here has any problem with what she chose. What we *do* have a problem with is when people only list the risks of CS but not the risks of attempted vag birth, or when they tell high-risk women to ignore medical advice in order to “get your VBAC.”

Sarah

Yes, it depends on the wishes of each individual woman. That’s why it’s best to consider the relative risks and benefits for both approaches, not just one. Personally, I am entirely uninterested in the fact that I’d be at higher risk of placental issues and future pregnancy loss following my section, because I know I won’t be having any more babies.

fiftyfifty1

“The rate of secondary infertility after a c section is also double that of a vaginal birth when all factors…are controlled for.”

Which study are you citing? Because some studies say the exact opposite–that when controlled for all factors, the infertility rate is minimally, if at all, increased.

Empress of the Iguana People

Sigh, and my freshly minted CNM friend keeps posting this kind of oh-so-cheerful stuff (not the ending, obviously) on facebook. Her youngest is 17 and she’s been a nurse for ages, so I don’t know what she’d been learning in her classes.

Amazed

My dad is big on the “Think positive! Let your mind heal you!” mindset in minor and even major matters but whenever the situation demands some real competence, he’s all, “OK, where are you? I’m hopping into the car. We’ll be in the ER in ten minutes.” Or, “Go to the hospital. Have that test. A problem? Ha! They’ll just tell you all is great. Go there, though.”

The thought that a medical professional can skip the second part is… scary. And even if she doesn’t actually practice this way, it’s irresponsible of her to even post it. Her status as a healthcare provider gives her additional legitimacy and it comes with responsibility. It isn’t two neighbours discussing the last great study in this or that that they never read but the media rushed on with the sensational coverage. It’s a professional.

sdsures

“My dad is big on the “Think positive! Let your mind heal you!””

I have a few family members like that. *eyeroll*

Amazed

Yeah, eyeroll is what I do quite often because he drones, he tries being positive and so on but at the end, it’s all talk. Talk the talk, don’t walk the walk. If he truly believed in this, he would have put his money where his mouth it. Then why say it? He’s in some kind of middle that I can’t see the logic of.

I try to remember that it could have been worse. He could have been practicing this nonsense, instead of recommending it as a ever so useful additional tool.

`fraid I just rolled my eyes again.

ETA: Ha! The very last example: on Wednesday, he didn’t tell the Intruder and SIL to let their mind heal Amazing Niece from the freaking poisonous plant she had eaten. He was damned glad that they had sped for the hospital. I guess it takes time to become the Grandpa from Hell, aka poor Ezekiel’s grandfather. I’m happy to announce that we didn’t get the same result. The kid was discharged today.

Mishimoo

Oh no! What did she eat?! Glad she’s okay and home again.

Amazed

Thank you. I am so very glad as well.

Trefoil, I think it’s called. Something that lives in a pot. Her mom was out of the room for a minute or two. Turned ot that this time was enough for Amazing Niece to knock the pot over and graze on the thing steadily. She had all the electro and not electro things in the hospital, poor kiddo.

My mom babysat her after she came home. She didn’t want to sit alone and only wanted to be held and cuddled but, fortunately, she seems to be up to her usual antics, namely eating all the books that she can get her hands upon and grinning.

Mishimoo

That would have been scary, a lot of indoor plants are REALLY nasty and contain fun things like oxalic acid or cyanogenic glycosides.

It’s so good that she’s back to normal even though she was cuddly, poor kiddo.

Amazed

Thank God, she’s fine now. Yesterday, they were visiting my grandmother who didn’t know about the accident. She told me how cheerful and smiling the little one was. Just a sweetie! Thank God. Gran still doesn’t know about the trefoil. Nothing in kiddo’s behavior was atypical.

sdsures

Glad to hear it!

Allie

OMG, for a second there I thought you wrote “her youngest is 17 and she’s been nursing for ages”! I’m only on my second cup of coffee. May need a third : )

Empress of the Iguana People

rofl. No, but she’s given microbard her bottle while I needed to chase minibard.

EmbraceYourInnerCrone

I don’t understand any of this, she was already at almost 41 weeks which is not necessarily good as the placenta can start deteriorating even earlier than that and the baby slowly starved to death. Her doctors also apparently recommended against VBAC and wanted her to have a repeat C-section (for the safety of both mother and baby I assume)

What about refusing a repeat C-section and just letting nature take it;s course seemed like a good idea.

Full disclosure my family has had more than it’s fair share of pregnancy complications and near misses (C-section due to large head, 11 lb 10oz baby with shoulder dystocia, pregnancy with fibroids, placenta previa with transverse lie, Rh factor, nuchal cord, Pre-eclampsia, HELLP syndrome) so with my one and only successful pregnancy I was paranoid about delivering safely. No one in my family subscribes to the “It will be all right if you just BELIEVE!!” theory. Nature is a bitch

There are way too many people(even those who should know better) who think C-section rates are too high and who give no thought to “too high for what?” My nephew is a prime example. His mother’s doctor had scheduled an induction because the baby was getting too big. The day before the induction his mom went into labor. Bad Shoulder dystocia with 11 lb 10 oz baby and small mother. He was delivered vaginally and spent a week in NICU most of it on oxygen and a tube. He is luck in that the damage to his shoulder is minimal. And all of that could probably have been avoided with a C-section…

EmbraceYourInnerCrone

I don’t think doctors are God or infallible, but they have gone through Pre-med, medical school and residency, plus specialization. That’s years and years of higher education and studying and seeing thousands of patients. Why would someone believe some random person on the internet as opposed to asking detailed questions of their doctor if they have doubts about whether a procedure is necessary?

When my car is repaired or serviced I DO try to make sure they are not charging be or doing un-needed things but I don’t tell them whether the brake shoes or rotor needs replacing.
When my water heater started leaking I discussed what size replacement one I needed and how hot I wanted it set at and asked why the new one needed a platform when the one one had none, but I didn’t just decide to put duct tape on the leak and wait to see what happened. I also checked with people I know who had used the same plumber to see how their work stood up over time before I hired the plumber.

I don’t get the “FIGHTING for MY VBAC!!!1!” Umm you are trying to get the baby from inside you to outside, alive and preferable in one piece with all it’s parts including it’s brain, fully functionally, with as little damage to you as possible.

Steph858

“Qualified Electricians only install MCBs, RCDs and thick wires so they can charge you more money. Lay Sparkies have other ways of knowing how to wire up a house. A DIYer instinctively knows what size wire to use for what purpose. Lay Sparkies keep 40A MCBs on hand to use on the rare occasions when an intervention is needed to the circuit.

Qualified Electicians will try to convince DIYers that circuits feeding large loads need expensive thick wire and costly safety devices to operate safely. But a Lay Sparkie recognises that you can Trust Electricity; a DIYer will never connect a load too large for cheap 1mm2 cable to feed. A Qualified Electrician will often play the ‘Electrical Fire’ card, but fear not: Lay Sparkies carry a CO2 extinguisher to use in the event that a circuit wired by a DIYer has a condition which was incompatible with electricity.”

Empress of the Iguana People

“lay sparkies” lol

kilda

LOL – or possibly TOO compatible with electricity.

sdsures

*major giggles* Can I post that on my FB page?

Steph858

Be my guest. But please include attribution (in tiny tiny print if you want); I might want to post this elsewhere and don’t want to be accused of plagiarism if someone sees my post of this elsewhere and happens across it on your facebook but not here.

sdsures

How should I appropriately reference you? (ie format)

Steph858

Just write “Originally posted by Steph858 at skepticalob.com”. Or words to that effect.

sdsures

OK.

Kris

A less popular thing I tell people is that before they swan on about the beauty of Mother Nature, they should consider that “she” has no NICU. Leaving nature in charge, you have strong babies and dead babies. Still want to hitch your wagon to that?

Daleth

That’s brilliant.

Sarah

Ooh, we had an 11lb 10oz baby with SD too! Not mine, thankfully.

BeatriceC

Sigh. What is wrong with people? I don’t necessarily blame the mother. She’s been lied to. I’ve likened NCB propaganda with cults before, and I still think it’s a relevant comparison, and as such, I often believe the mothers as victims as well as their babies. I just don’t know what to think sometimes.

Madtowngirl

“Cults” is a fantastic way to describe it. I just watched Leah Remini’s new series about leaving the church of Scientology – NCB propaganda sounds oddly familiar in it’s treatment of those who leave it, or worse, lose babies because of it.

LisaL

GoFundMe? No…. you don’t deserve money from anyone else b/c you were too stupid and stubborn to put your baby’s life before your idiotic want of a VBAC. So sad for that poor baby that never had a chance b/c momma thought she knew better than a doctor.

Steph858

I visited the GoFundMe page out of curiosity, hoping she was raising funds to spread her story as cautionary tale to warn others against making the same mistakes she did. I was sadly disappointed to see she just wants money for a funeral and a memorial. These would be worthy candidates for donation in the case of a baby whose death was tragically unavoidable; in her case, I won’t be donating a single penny.

Krystle Dolbow

The admin, who actively cheered her on as well, is the one who set up the GFM. Maybe because she felt guilty? Idk. But it’s pathetic. “I know I cheered you on to go against medical advice, as well as let a bunch of other women do so too, and because of that your baby died, but here. . Have some money”. Only a handful of people donated, too. Goes to show you how “loyal” the women in the group that cheer you on and “support” you, can be. If you have a bad outcome, they blame the mom for “not trusting her body and birth enough”, then ban her and delete any mention of her. It’s sick.

Mark

So what did the people in the group say after the baby was born dead?

The Bofa on the Sofa

That’s a darn good question

Mark

For me it is not so much the mistakes made that makes me angry it’s the coverup or rationalization that almost always happens.

Hardly anyone seems to take responsibility these days. I really would love to hear what they had to say

The Bofa on the Sofa

I wouldn’t be surprised if they have made the group (more?) private to prevent anyone calling them out.

Mark

Don’t you just love the echo chambers people create?

I don’t care if it’s a group I am opposed against or indifferent. If your ideas can’t stand up to reasonable criticism then …

While IMO you really can’t blame them if someone followed their non professional opinions, the little that I see their was no reasonable advice given. Like risk/reward or getting another opinion.

I would really expect them to have learned a lesson.

Why do I have a feeling I will get a new age ‘religious’ it wasn’t meant to be?

While it is healthy to realize life can be harsh and bad things happen. That people do die in childbirth. It is most definitely unhealthy to not avoid serious risks that could be avoided so you can let nature take its course.

Steph858

I don’t know what Cassandra’s reasons were for being so vehemently opposed to a C-Section that she let her daughter die, so I’m not saying this is the case for her, but I’ve noticed there’s a lot of overlap between religious fundamentalist and natural parenting groups. It seems very strange to me that there are people out there who think that having an abortion is tantamount to murder, but killing a baby by insisting on a natural birth at all costs is A-OK.

Erin

You see the “vehemently opposed” element in the birth trauma group I’m in and to be honest, it’s going to take every last bit of strength I have to walk into the hospital for my repeat because my son’s arrival was such a horrific, violating and repulsive experience (unfortunate circumstances).

There seems to be a degree of assumption that we’re entitled to the births (and the babies) we want and until that gets truly tackled (by health services too…glaring at the NHS in particular) then this is always going to happen. Whilst ignoring or fighting your Doctors is described as empowerment and normal birth is held up as the pinnacle of a woman’s achievement then this is the other side of the coin.

It’s heartbreaking but it’s also reminded me of why I made the decision I have. I want to leave hospital with a living breathing child. I want a sibling for my son. I want days at the zoo with both my children. I want to watch them grow up together and whilst there are no guarantees about the future, I’d rather a repeat of my son’s arrival than bury a baby who could have survived but for my cowardice or stubbornness.

PeggySue

You are my hero. I wish all those things for you!

Glia

I truly hope that you get all of those things, AND a repeat experience that is gentle, respectful, and different in every way that hurt you before. I was also terrified before my planned CS, but I knew I would have pretty much been willing to do the CS on myself to protect my baby and avoid another loss.

Erin

Thanks. Unless something goes very pear shaped, I will be unconscious for it as I don’t believe it’s possible to have a better experience whilst awake but I’m definitely hoping that it’s going to be less traumatic.

Hopefully this time I’ll want to take the baby home with me.

Sean Jungian

That bit about “we know we’ll see her…in heaven” brought that to my mind, too. It’s almost like they don’t believe the baby is dead? AFAIK most christians believe in an afterlife, so not sure if it’s really fundamentalism, but it struck me oddly as well.

Ash101

It’s still very early in the grieving process – I’m sure that at the time of posting, the mother still hadn’t had time to fully digest what has happened. In a way, yeah, she may not have deep down believed her baby is dead. She may still, deep down, have felt like she’s in a nightmare.

I think saying that they know they’ll see their daughter in heaven is, at it’s heart, a way of acknowledging their daughter’s personhood and that she will always be a part of them – that they’ll always remember her.

A few weeks out is too soon to expect a grieving family to fully understand the extent to which they were exploited and ultimately, betrayed, by the NCB profiteers.

As for the religious fundamentalist overlap: I definitely see that in the NCB movement, although the far-left, secular crunchy types can have a tendency toward NCB too. I categorize NCB as a cult. Humans are very susceptible to cults. It takes us a long time to fully disentangle ourselves from them and denounce them – if we ever do.

Sean Jungian

I agree that it’s still early in the grieving process. It just stood out to me. I’ve not been in their situation so I can’t claim to understand, and even if I did have experience with this, it wouldn’t qualify me to comment on their grief.

AA

Wishing to see a loved one in heaven is pretty common among Christians in the USA. I don’t think it’s stranger than the other religious phrases I hear people say.

Sean Jungian

I did mention that in my comment.

Steph858

When I’m in a contrarian mood, I’ll respond to Fundamentalist Christian “Abortion is murder” types with the following:

Me: Do you believe that babies who die before or shortly after birth go to heaven?
Fundie: Yes.
Me: Do you believe that anyone who reaches the age of reason (I rarely quibble about where this ought to be set in these cases as it’s not that important; for the sake of this argument I accept whatever age they agree with which is usually somewhere in the teens) MIGHT go to hell?
Fundie: Only if they turn their back on God/Don’t get saved/etc.
Me: So there’s a chance that anyone who is born and grows to a sufficient age could go to hell, right? Anyone can turn their back on God, even a child of devout parents. much less a child of a godless heathen.
Fundie: Yes, but I make it my mission to save as many people as I can.
Me: A laudable mission, I’m sure. Anyway, so, to cut to the chase, an aborted baby goes straight to heaven but a baby who is born and grows up MIGHT go to hell?
Fundie: Well, that’s a harsh way of putting it, but I suppose so.
Me: So by having an abortion, the mother’s actually making 100% sure that her baby goes to heaven. Why don’t you support that?
Fundie: Because then the mother will go to hell for committing murder.
Me: She could get saved and forgiven her sins afterwards. And if not, she was probably a godless heathen destined for hell anyway, right?

I think you get the gist of my argument. Always confuses the hell out of religious pro-lifers.

Empress of the Iguana People

you’re evil *grins*

sdsures

I like your spirit. 😀

Azuran

You might add even more to this.
So……a bundle of cell goes to heaven…..as what? a bundle of cells? a newborn? a kid? an adult?
Or even for that matter, a stillborn……is he still a baby in heaven?
In lets say 50 years, when you go to heaven, what is waiting for you there? Do you have a baby in heaven? are you going to spend the rest of eternity with your heaven baby? (and does it poop?)
Has your baby just been baby chilling in heaven for 50 years waiting for you?
Or did it pop up there as a baby and was raised by some other dead family member? In that case, it probably wouldn’t care that much for you.
Or did it immediately became a kid or an adult in heaven? And what kind of knowledge would it have?

One of my coworker had 10 early miscarriages. Is she going to be greeted in heaven with 10 adult kids she knows nothing about that have been waiting for her for decades? Or 10 microscopic bundle of cells?

Steph858

Questions along that line (along with similar questions like “Will an amputee get his missing limb back in heaven?”) usually get a pat answer along the lines of “In heaven we will all be perfect. Only God knows what perfection is so it would be pointless for me to speculate what heaven might be like.”

Actually, my ‘Why is abortion wrong if it guarantees the baby gets to heaven?’ question usually gets a pat answer along the lines of “God (read: my pastor) said it’s wrong, therefore it’s wrong. Only God knows the whys and wherefores as to why it’s wrong.”

Funny how religious leaders know that “God says you must do this and mustn’t do that,” but when someone asks an awkward question about WHY God said that God suddenly becomes an evasive and unknowable mystery whom only fools would try to understand.

Cody

Hahahahahaha im going to be thinking about that one for a while.

KeeperOfTheBooks

Some of the vibes I’ve gotten from those groups imply that midwives (particularly, of course, CPMs and LMs) don’t prescribe birth control or do C-sections or sterilizations or abortions, so they’re the Good Guys (plus, of course, a heavy dose of biological essentialism). OBs, on the other hand, do (or, in the case of abortion, some do, some don’t), and they’re all cut-happy golfing monsters anyhow, so they both Won’t Respect What God Designed Your Body To Do (TM) *and* might mention that, say, many pregnancies in a short period of time can be hard on a woman’s body.
I know at least one CPM in training who was brought up in those sort of circles; her greatest fear is going to a hospital while in labor because she honestly thinks that an OB might have her physically restrained so he can perform an “unnecessarian” and perhaps a tubal ligation without telling her in the bargain.

Cody

All it takes is one shitty OB to colour people’s opinion though. We have some OBs in my area that are so phenomenal with patients that I can’t put it in to words.

Meanwhile, there is one OB at a local hospital who is rude and sometimes downright cruel, and does routine episiotomities. Now he might be the best at doing c-sections or have fantastic skills at other things, but the public isn’t privy to that info so all women have to go by is what they experience.

IMO, you have the fringe outliers of the NCB movement, and then you have women who wouldn’t have joined that cohort, but then maybe they gave birth with a doctor like that, or their sister or friend did. Now all of a sudden, they’re part of the group. This is very much motivated by fear and some of it is legitimate.

I know this is an unpopular opinion here, but women do have legitimate concerns with modern obstetrics and they are only being addressed at a snails pace. Until that changes, the NCB shit storm will continue.

I know people will say things like “I don’t care how a doctor treats me as long as she/he is competent” but I think that trivializes the flat out bad experiences that some women have.

KeeperOfTheBooks

No arguments there at all. I think it was this thread on which I described my experiences with my OB vs one of his partners. My OB is amazing and wonderful. His partner–well, I just might refuse to let him treat me if he were on call and I needed a CS, and if his competence in deliveries and surgery is as shoddy as it is for a basic on-call phone consultation, I’m not sure how he manages to keep practicing.
I also think that having a debriefing talk a few weeks after labor could be very helpful in not driving women to the NCB movement due to frightening experiences in a hospital–you know, “Do you have any questions about how your labor or delivery went, or why I did what I did? I know it got really intense there.” That sort of thing.

Cody

That’s exactly what many women need.

Amy Tuteur, MD

Dr. Amy Tuteur is an obstetrician gynecologist. She received her undergraduate degree from Harvard College in 1979 and her medical degree from Boston University School of Medicine in 1984. Dr. Tuteur is a former clinical instructor at Harvard Medical School. She left the practice of medicine to raise her four children. Her book, Push Back: Guilt in the Age of Natural Parenting (HarperCollins) was published in 2016. She can be reached at DrAmy5 at aol dot com...
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